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Nitrate in stable CAPD patients and during peritonitis

C E Douma1, D R de Waart, D Zemel

  • 1Department of Medicine, Academic Medical Center, Amsterdam, The Netherlands.

Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis
|January 1, 1995
PubMed
Summary

Nitrate levels in peritoneal dialysis fluid suggest local nitric oxide production during peritonitis, contributing to vasodilation. In stable patients, nitrate primarily diffuses from circulation.

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Area of Science:

  • Nephrology
  • Physiology
  • Biochemistry

Background:

  • Continuous ambulatory peritoneal dialysis (CAPD) involves vasodilation of peritoneal vessels.
  • Nitric oxide (NO) is a known vasodilator in various organs.
  • Nitrate, a stable NO metabolite, can be measured in biological fluids.

Purpose of the Study:

  • To measure nitrate levels in plasma and dialysate of CAPD patients.
  • To investigate the role of NO-derived nitrate in peritoneal dialysis and peritonitis.
  • To differentiate between systemic diffusion and local production of nitrate.

Main Methods:

  • Measurement of nitrate in plasma and dialysate of stable CAPD patients and during peritonitis.
  • Calculation of the mass transfer area coefficient (MTAC) for nitrate and creatinine.

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  • Analysis of dialysate/plasma (D/P) ratios of nitrate and tumor necrosis factor-alpha (TNF-α).

    • Main Results:

    • MTAC of nitrate was comparable to creatinine in stable CAPD patients, suggesting diffusion from circulation.
    • Dialysate/plasma (D/P) ratios of nitrate were significantly higher during the acute phase of peritonitis (1.47) compared to recovery (1.07).
    • No correlation was found between D/P nitrate and D/P TNF-α during peritonitis.

    Conclusions:

    • Dialysate nitrate levels in stable CAPD patients are primarily influenced by diffusion from the circulation.
    • Elevated D/P nitrate ratios during peritonitis indicate local nitric oxide production.
    • Local NO production may contribute to the significant vasodilation observed during peritonitis.